Related Experiment Videos
An exploration of central nervous system medication use and outcomes in stroke rehabilitation
Brendan Conroy1, Richard Zorowitz, Susan D Horn
1Stroke Recovery Program, National Rehabilitation Hospital, Washington, DC, USA.
Unlabelled:
Conroy B, Zorowitz R, Horn SD, Ryser DK, Teraoka J, Smout RJ. An exploration of central nervous system medication use and outcomes in stroke rehabilitation.
Objective:
To study associations between neurobehavioral impairments, use of neurotropic medications, and outcomes for inpatient stroke rehabilitation, controlling for a variety of confounding variables.
Design:
Observational cohort study of post-stroke rehabilitation.
Setting:
Six inpatient rehabilitation hospitals in the United States.
Participants:
Patients with moderate or severe strokes (N=919).
Interventions:
Not applicable.
Main Outcome Measures:
Discharge disposition, FIM score change, and rehabilitation length of stay (LOS).
Results:
Neurobehavioral impairments and use of many medications, including first-generation selective serotonin reuptake inhibitors, older traditional antipsychotic medications, and anti-Parkinsonian neuro-stimulants, have a statistical association with poorer outcomes, whereas use of the atypical antipsychotic medications has a positive association with improvement in motor FIM scores. Counter-intuitively, use of opioid analgesics is associated with a larger motor FIM score change but not an increase in LOS or reduced percentage of discharge to community. There was significant variation in use of neurotropic medications among the 6 study sites during inpatient stroke rehabilitation.
Conclusions:
There are many opportunities to enhance a stroke survivor's ability to benefit from acute inpatient stroke rehabilitation through improved understanding of associations of neurotropic medications with outcomes for different patient groups.